ESTRO 35 Abstract Book

S32 ESTRO 35 2016 _____________________________________________________________________________________________________

centroid-based and the volume overlap methods. 42% of centroids mapped using RIR were located peripheral to the same centroids mapped using DIR (p= 0.0002), and 46% of the rGTVs whole volumes mapped using RIR were located at a rather peripheral TVs compared to the same rGTVs mapped using DIR (p< 0.0001). rGTVs mapped using DIR had significantly higher mean doses when compared to rGTVs mapped rigidly (mean dose 70 vs. 69 Gy, p = 0.03). According to the proposed classification 22 out of 26 failures were of type A as assessed by DIR method compared to 18 out of 26 for the RIR because of the tendencey of RIR to assign failures more peripherally.

OC-0071 Analysis and reporting patterns of failure in the era of IMRT: head and neck cancer applications A.S.R. Mohamed 1 , D.I. Rosenthal 1 , M.J. Awan 2 , A.S. Garden 1 , E. Kocak-Uzel 3 , A.M. Belal 4 , A.G. El-Gowily 5 , J. Phan 1 , B.M. Beadle 1 , G.B. Gunn 1 , C.D. Fuller 1 2 Case Western University, Radiation Oncology, Cleveland, USA 3 Şişli Etfal Teaching and Research Hospital, Radiation Oncology, Istanbul, Turkey 4 Alexandria University, Radiation Oncology, Alexanria, Egypt 5 Alexandria University, radiation Oncology, Alexandria, Egypt Purpose or Objective: To develop a methodology to standardize the analysis and reporting of the patterns of loco-regional failure after IMRT of head and neck cancer. Material and Methods: Patients with evidence of local and/or regional failure following IMRT for head-and-neck cancer at MD Anderson cancer center were retrospectively reviewed under approved IRB protocol. Manually delineated recurrent gross disease (rGTV) on the diagnostic CT documenting recurrence (rCT) was co-registered with the original planning CT (pCT) using both deformable (DIR) and rigid (RIR) image registration software. Subsequently, mapped rGTVs were compared relative to original planning target volumes (TVs) and dose using volume overlap and centroid-based approaches. Failures were then classified into five types based on combined spatial and dosimetric criteria; A (central high dose), B (central elective dose), C (peripheral high dose), D (peripheral elective dose), and E (extraneous dose) as illustrated in figure 1.Paired-samples Wilcoxon signed rank test was used to compare analysis metrics for RIR versus DIR registration techniques. 1 MD Anderson Cancer Center, Radiation Oncology, Houston, USA

Conclusion: DIR-based registration methods showed that the vast majority of failures originated in the high dose target volumes and received full prescribed doses suggesting biological rather than technology-related causes of failure. Validated DIR-based registration is recommended for accurate failure characterization and a novel typology- indicative taxonomy is recommended for failure reporting in the IMRT era. OC-0072 Respiratory time-resolved 4D MR imaging for RT applications with acquisition times below one minute C.M. Rank 1 German Cancer Research Center DKFZ, Medical Physics in Radiology, Heidelberg, Germany 1 , T. Heußer 1 , A. Wetscherek 1 , A. Pfaffenberger 2 , M. Kachelrieß 1 2 German Cancer Research Center DKFZ, Medical Physics in Radiation Oncology, Heidelberg, Germany Purpose or Objective: 4D MRI has been proposed to improve respiratory motion estimation in radiotherapy (RT), aiming to achieve a higher treatment accuracy in the thorax and the upper abdomen. In contrast to 4D CT, acquisition time in 4D MRI is not limited by radiation dose, such that multiple breathing cycles can be imaged routinely. However, standard MR reconstruction methods, such as gated gridding, have limitations in either temporal or spatial resolution, signal-to- noise ratio (SNR), contrast-to-noise ratio (CNR) and artifact level or demand inappropriately long acquisition times. The purpose of this study is to provide high quality 4D MR images from super short acquisitions. Material and Methods: MR data covering the thorax and upper abdomen of three free-breathing volunteers were acquired at a 1.5 T Siemens Aera system. We applied a gradient echo sequence with radial stack-of-stars sampling and golden angle radial spacing: total acquisition time: 37 s, slice orientation: coronal, field-of-view: 400×400×192 mm^3, voxel size: 1.6×1.6×4.0 mm^3, TR/TE = 2.48/1.23 ms, 240 spokes per slice, undersampling factor: 16.8, flip angle: 12°. MR data were sorted into 20 overlapping 10% wide motion phase bins employing intrinsic MR gating. Respiratory motion compensated (MoCo) 4D MR images were generated using our

Results: A total of 21 patients were identified. Patient, disease, and treatment characteristics are summarized in table 1. The registration method independently affected the spatial location of mapped failures (n=26 lesions). Failures mapped using DIR were significantly assigned to more central TVs compared to failures mapped using RIR for both the